Notice: This CMS-approved document has been submitted - Philips ...
Notice: This CMS-approved document has been submitted - Philips ... Notice: This CMS-approved document has been submitted - Philips ...
CMS-1403-FC the 2009 PQRI in an effort to expand opportunities for eligible professionals to participate in PQRI. Comment: We received many comments urging us to ensure that all eligible professionals have meaningful opportunities to participate in the PQRI. Some commenters were specifically concerned that funding for the Quality Insights of Pennsylvania (QIP) project to develop nonphysician quality measures has ended and hoped that CMS will continue to extend funding in the future for the development and implementation of quality measures for nonphysicians as well as to move measures already developed by the QIP through the NQF endorsement and/or AQA approval process. Several commenters were also concerned that therapists who work in certain outpatient settings (for example, acute care hospitals, skilled nursing facilities, comprehensive outpatient rehabilitation facilities, or rehabilitation agencies) are unable to participate in PQRI since they do not use the 1500 or 837-P claim form and instead submit claims on the UB-04 or 837-I form where there is no place to report the individual National Provider Identifier (NPI) of the eligible professional furnishing the service. The commenters recommended registry-based alternatives for PQRI participation. 538
CMS-1403-FC A few commenters noted that pathologists who bill via independent laboratories are also not able to participate in the PQRI because we are not yet able to capture this billing situation. Response: We agree with the goal of providing as many eligible professionals the opportunity to participate in the PQRI as is practical and feasible. As we stated in the CY 2009 PFS proposed rule (73 FR 36566), one of the considerations we employed in the selection of measures for the 2009 PQRI is to select measures that increase the scope of applicability of measures to services furnished to Medicare beneficiaries and expand opportunities for eligible professionals to participate in PQRI. We seek to increase the circumstances where eligible professionals have at least three measures applicable to their practice. For the 2008 PQRI, we supported, via contract with QIP, the development of structural measures and measures applicable to a broad cross-section of PQRI eligible professionals, including some NPPs who had few or no measures available in the 2007 PQRI. We prioritized development of these measures available or otherwise in development and on a need to address as broad a cross-section of eligible professions or specialties as possible within the limited volume of measures for which we 539
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<strong>CMS</strong>-1403-FC<br />
A few commenters noted that pathologists who bill via<br />
independent laboratories are also not able to participate<br />
in the PQRI because we are not yet able to capture this<br />
billing situation.<br />
Response: We agree with the goal of providing as many<br />
eligible professionals the opportunity to participate in<br />
the PQRI as is practical and feasible. As we stated in the<br />
CY 2009 PFS proposed rule (73 FR 36566), one of the<br />
considerations we employed in the selection of measures for<br />
the 2009 PQRI is to select measures that increase the scope<br />
of applicability of measures to services furnished to<br />
Medicare beneficiaries and expand opportunities for<br />
eligible professionals to participate in PQRI. We seek to<br />
increase the circumstances where eligible professionals<br />
have at least three measures applicable to their practice.<br />
For the 2008 PQRI, we supported, via contract with<br />
QIP, the development of structural measures and measures<br />
applicable to a broad cross-section of PQRI eligible<br />
professionals, including some NPPs who had few or no<br />
measures available in the 2007 PQRI. We prioritized<br />
development of these measures available or otherwise in<br />
development and on a need to address as broad a<br />
cross-section of eligible professions or specialties as<br />
possible within the limited volume of measures for which we<br />
539